Why 90 % of cardiologists suffer from coronary blindness ?
Note :This is a copy of my earlier blog on coronary micro-circulation published few years ago.Recently this got numerous hits .Hence I have just reposted it with slight modification.
Human coronary circulation stands unique among others as it is a life-sustaining circulation.It is indeed a great medical achievement to visualise the right and left coronary artery system by coronary angiogram. Actually, what we see is only a fraction of the surface area of coronary circulation .The surface area of epicardial coronary arteries constitutes less than 5 % of entire coronary vascular tree .
And . . .
An in vitro heart with special catheters showing the true extent of coronary circulation: Courtesy http://eurheartj.oxfordjournals.org/content/28/3/278.full.pdf+html
This is the reason normal coronary angiogram can never mean normal coronary circulation !
This huge gap in our perception is the single important factor that explains the vagaries of modern coronary care .
This also make any clinical coronary scenario a reality .
“A patient with normal coronary angiogram getting a myocardial infarction , the next day and a severe triple vessel disease living comfortably for decades with medical management”
So , it is essentially a false sense of scientific accomplishment by the cardiac scientists at least in the of coronary circulatory physiology.
What determines the extent of these invisible coronary micro cir...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: dr s venkatesan Tags: cardaic physiology cardiac physiology Cardiology -Coronary collateral circulation Cardiology quotes coronary angiogram coronary blindness coronary micro circulation Source Type: blogs
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